Enshera Mustafa holds her four-year-old granddaughter Nada outside a clinic near the Syrian-Jordanian border. Jordan sealed the border with Syria after a bombing last year and now allows a small number of refugees across for medical treatment before sending them back.

Jane Arraf
/ NPR

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In the middle of the desert, hundreds of miles from the nearest city, 60,000 Syrians are camped out along the Syrian and Jordanian border in what has become one of the biggest and most desperate refugee settlements in the region. Few outsiders have ever seen it.

NPR visited an area near the camp last week in a trip organized by the Jordanian military.

Aid groups, who have no direct access to the three-year-old camp, track its growth by analyzing satellite images showing thousands of makeshift tents clustered between two berms — earthen embankments in a no-man's land along Jordan's far northeastern border.

Jordan says the camp, located in no-man's land between the two countries, is infiltrated by ISIS and won't allow any aid workers to go there. With limited food getting through, some children are in danger of starving.

"The United Nations staff doesn't have access to the no-man's land, so the assistance has to be provided from this end," Helene Daubelcour, a spokeswoman for the U.N. High Commissioner for Refugees, tells NPR at a U.N.-funded clinic on the Jordanian side of the border, more than a mile from the camp. "The area is now a closed military zone, so we are helping as close as we can — but we cannot go on the other side of the berm."

From the closest point that aid workers are allowed to go, the tents in the camp are visible only as white dots in the distance.

Sand swirls around the aid compound, which is protected by Jordanian tanks and edged with barbed wire. Outside a clinic operating from a trailer, refugee women sit in plastic chairs, holding coughing children.

Enshara Mustafa has brought her four-year-old granddaughter, Nada. The little girl with wide brown eyes burned her leg with scalding water two days earlier. But she also suffers from asthma, and they couldn't move her in a sandstorm the day before.

"It's like death," says Mustafa, when I ask her what the camp is like. "They send us aid every two or three months. We can't even afford to buy an aspirin."

She and her family left Homs more than a year ago, she says, after their house was destroyed.

"We kept moving from one place to another, and every place we went, there were airstrikes," she says. Finally, they reached the Jordanian border and could go no further.

Jordan has always restricted access to the refugees at Rukban, but after a suicide car bomb at a checkpoint killed seven Jordanian border guards last June, it sealed the border with Syria entirely.

ISIS claimed responsibility for the attack.

"Everything is different after the bombing," says Sabah Jaradeen, a retired Jordanian army officer who runs a UNICEF-funded feeding center for children. She says before the attack and the restrictions, she and her team used to see more than 100 children a day – assessing them and treating the ones who were malnourished. Now, she says, "The number depends on the military bringing them in the morning and taking them back."

UNICEF says on a typical day there are fewer than a dozen children brought in. It has seen 16 severely malnourished infants since its clinic opened in December.

In November, the U.N. was allowed to drop food across the border, after months of negotiations with the Jordanian government. To reduce the risk, Jordan required that it be dropped into the no-man's land from cranes.

The U.N. has set up a center in the neutral zone, where refugee community leaders are responsible for distributing U.N.-provided food. But the last delivery of a month's supply of food for the refugees ran out more than a month ago. People are relying, when they can, on stockpiled food, are using whatever money they have to buy more — or, as with the malnourished children, they're not eating at all.

As for water, to minimize risk, UNICEF pumps it into Rukban from Jordanian reservoirs rather than trucking it in. Calculating the rate of water consumption, in addition to analyzing the satellite imagery, is what helps the U.N. estimate the number of people in the camp, the U.N.'s Daubelcour says.

Only refugees who are brought to a checkpoint by Rukban community leaders and are searched by Jordanian border guards are allowed access to the U.N. medical clinic. The border guards transport patients to the clinic and then take them back again to the checkpoint after they are treated.

"We try our best to advocate with the government of Jordan," says Samir Badran of UNICEF, "and we hope there will be a solution in the long run."

Jordanian Brig. Gen. Barakat al-Aqeel says his border force is implementing a political decision by the Jordanian government to close the border. While 90 percent of the residents of Rukban are ordinary civilians, he says, another 10 percent are affiliated with ISIS.

"The danger is very high," he tells us. "We are always expecting the worst regarding the possibility of anyone carrying explosives to blow up our soldiers."

As we speak, residents of the camp bring an elderly man on a stretcher to a waiting ambulance on the Jordanian side of the border. The man's family members stop at the nearest point they're allowed to come – a checkpoint between sand-filled barriers topped with barbed wire.

"It's far from ideal if you have to operate without full access to the population," Daubelcour says. "It's difficult to understand their needs and address them in the way we would like to do."

And then she and the other U.N. staff leave to return to Amman. The U.N.'s own security rules deem this desert too dangerous for their staff to be out after dark.

For the past two years, aid officials have been reluctant to speak publicly about Rukban, afraid of upsetting the Jordanian government and jeopardizing their chances of access to the camp. Jordan, which has taken in some 650,000 Syrian refugees, has said it is at the breaking point and called for more international aid.

Copyright 2017 NPR. To see more, visit http://www.npr.org/.

KELLY MCEVERS, HOST:

Tens of thousands of Syrians have gathered in the desert near the Jordanian border. It's a remote area, a last option for people who have nowhere else to go. They're hundreds of miles from any town. Some of the children are starving. Aid groups are barred from going to them. NPR's Jane Arraf traveled with the Jordanian military to get as close as she could.

JANE ARRAF, BYLINE: This is the rattling and the squeaking of a flatbed truck. There is no road here, and we're driving through the desert. On the right there is a big sand embankment, a berm. And there's nothing else around for miles except off-in-the-distance tanks facing in the direction of the Syrian border. It's a little hard to see because there's so much dust.

We're headed to the border crossing of Rukban in the middle of the desert, 300 miles from the Jordanian capital and almost 200 miles from the nearest Syrian city. We finally arrive at a small compound behind barbed wire. A few miles away, there are more than 60,000 refugees in a no-man's-land between Jordan and Syria. Jordan sealed its border after a bombing last year at a security checkpoint, and this is as far as journalists and aid agencies can go.

HELENE DAUBELCOUR: The area is now a closed military zone. So we are helping as close as we can, but we cannot go on the other side of the berm.

ARRAF: That's Helene Daubelcour, a spokeswoman for the U.N.'s refugee agency. The little they know about Rukban camp is from satellite images and community leaders screened and searched before being allowed to come across.

DAUBELCOUR: You can imagine that the population you have here is the population of a city - of a small city where you would normally find hospitals, schools, water, electricity. And here, apart from the water that is being delivered, you don't have this infrastructure.

ARRAF: It's just desert, and the situation is dire, she says.

DAUBELCOUR: We have to go, so...

UNIDENTIFIED MAN: OK.

ARRAF: And then she and the other U.N. staff leave. U.N. rules prevent them from staying in this desert after dark. Subcontractors operate the clinics. After the suicide bombing last year, Jordan shut down a much larger aid operation closer to the camp. This clinic has been open since December. It treats only refugees brought here by the Jordanian military and then returned when they're well.

One of them is Enshera Mustafa. She's here with her 4-year-old granddaughter, Nada. Nada is being treated for a burned leg and severe asthma.

ENSHERA MUSTAFA: (Through interpreter) Life there is like death. They send us food every two or three months but nothing else. We can't afford to buy an aspirin.

ARRAF: The Rukban camp was their last option. They had fled the Syrian city of Homs after their house was destroyed, and then they moved three more times, trying to stay ahead of the airstrikes. Finally they ended up at Rukban. Like almost all the refugees there, they can't go forward, and they can't go back. The U.N. supplies water and tries to distribute food, blankets and other supplies. But without being there, it doesn't know if the aid is getting to everyone. More than a month after the latest food distribution ran out, it's still negotiating the next one with the Jordanian government.

SABAH JARADEEN: This green one - it means normal. This one - it means severe malnutrition.

ARRAF: At the infant feeding center on the compound, Sabah Jaradeen, a retired Jordanian Army lieutenant colonel, shows me a tape measure she uses to determine if babies are underweight. The U.N. says since it opened the clinic three months ago, it's seen 16 infants so malnourished they would have died if they hadn't have been treated.

We're taken to a checkpoint for our only glimpse of the camp. But it's still more than a mile away, and it's barely visible. The Jordanian commander in charge of the border, General Barakat al-Aqeel, says although 90 percent of the refugees in Rukban are ordinary civilians, ISIS has infiltrated the camp.

ARRAF: This checkpoint with sand-filled barriers and barbed wire is the only point where refugees can come to seek help.

(SOUNDBITE OF SIRENS)

ARRAF: That's the sound of an ambulance that is just carrying an ill man who has been brought from the camp back to the clinic. He was loaded onto a stretcher here, but his family isn't allowed to come. I can see them standing about 300 feet away under barbed wire near HESCO barriers, but they're not allowed to approach. And we're not allowed to go any further.

UNIDENTIFIED SOLDIER: (Foreign language spoken).

ARRAF: Get back, a soldier tells us as a group of refugees walk towards us. We stop, and he allows them to come talk to us for a minute.

JLILLA: (Foreign language spoken).

ARRAF: There's a group of children. Their aunt, Jlilla, tells me they're trying to reunite the children with their parents who were allowed into Jordan for medical treatment more than a year ago. The children have only a few minutes to tell their story to journalists who only know their camp from satellite images, and then they're quickly led back to join the tens of thousands of unseen refugees on the far edge of the Syrian conflict. Jane Arraf, NPR News at the Rukban border crossing on the Jordanian-Syrian border. Transcript provided by NPR, Copyright NPR.